The old vision of what a nursing home does for the elderly unfortunately still holds true today.

The scene of grand-paw and maw-maw sitting in rocking chairs at a nursing home slowly watching their final years pass before their eyes is clear in the minds of many people. Nursing homes and other long term care facilities have long been known as places where the old go to die. But those stigmas attached to these types of health care facilities are slowly fading away as more and more people are turning to these centers to give health care and the quality of life, not death, unimagined before.

In an editorial board interview with the staff of the Meridian Star, administrators and directors from state and local organizations and facilities sat down to wipe away many of the lingering misconceptions in regards to nursing homes, personal care homes and facilities geared toward the mentally disabled. Their goal was to show that these types of health care centers have evolved into the 21st century and are viable alternatives to hospital care.

In attendance for the meeting were Vanessa Henderson, executive director of the Mississippi Health Care Association (MHCA), Gwen Causey, director of Long Term Care Quality and Regulatory Services for MHCA, Wanda Kennedy, director of Nursing Home Services for the East Mississippi State Hospital, and Brad Baker, administrator for Poplar Springs Nursing Center in Meridian.

Henderson said the MHCA member facilities have changed in many respects. Mainly, they provide health care for the very sick who are looking for alternatives to traditional hospital care and for improved care toward the quality of life many look for in the twilight of their lives.

"Nursing homes aren't what they used to be," said Henderson. "We consider it very, very important to provide improved quality of life to our residents. They are our customers and we value them greatly."

The MHCA was established as a trade association in 1953. With approximately 219 members, MHCA is Mississippi's oldest and largest association of nursing homes, personal care homes, and other long term care facilities.

The MHCA is the state affiliate of the American Health Care Association, and as such, participates in national health care events and forums.

The MHCA membership includes freestanding nursing homes as well as, nursing homes in a hospital-based setting and personal care/assisted living facilities. Member facilities provide care to such diverse groups as the frail elderly, the mentally disabled, veterans groups, as well as residential and personal care to residents requiring only assistance in a minimum number of activities of daily living.

The MHCA provides its members with educational programs, legislative services, and government services.

The MHCA encourages "safety in the workplace" for its members' employees by making participation in the MHCA Self Insurers' Fund available to qualifying facilities. The Fund operates under the laws and regulations of the State of Mississippi and the Workers' Compensation Commission.

The Mississippi State Department of Health (MSDH) licenses all MHCA members. The MSDH Division of Health Facilities Licensure and Certification certifies member nursing homes for participation in the Medicaid and Medicare programs.

MHCA member nursing homes are regulated by the Centers for Medicare and Medicaid Services (CMS), Washington D.C.

The primary funding source for nursing home patients in Mississippi is the Medicaid program, a division of the Office of the Governor. The Medicaid program in Mississippi is funded by appropriations made by the state legislature and by matching funds from the federal government.

The MHCA membership provides care to approximately 15,000 patients and residents annually. MHCA members annually provide employment to approximately 12,000 Mississippians in various professional capacities.

Member nursing homes operate under strict Medicaid and Medicare regulations mandated by the federal government.

Nursing homes and long term care facilities are subject to all state and federal laws and regulations, such as OSHA, Workers' Compensation, labor and unemployment, and the Americans with Disabilities Act, just as any other employer. Generally, any law that affects business and employers in Mississippi affects nursing homes and other long term care facilities as an employer and a business.

In addition to the many services provided by MHCA, it also provides the Mississippi Health Care Foundation helps bridge the gap between the quality of care provided in nursing home facilities and those special emotional and physical needs not covered by insurance policies, Medicare, Medicaid, even family members. The Foundation organizes special outings and events to fulfill life-long dreams of nursing home residents.

"It has been proven in studies that people who are involved in activities are much healthier individuals," said Baker. "We try to keep our residents busy, both physically and mentally and it really pays off in the long run when you look at how their lives have been enhanced."

The numbers seem to back up those statements along with other aspects of long term care facilities in the state of Mississippi.

Every year MHCA member facilities take part in a survey program overseen by an outside agency, My InnerView, based in Wisconsin. The latest numbers show the member facilities of the MHCA are at the national average in all categories such as overall satisfaction, safety inside the facility, cleanliness, quality nursing care, quality rehabilitation therapy techniques and much more. It is a source of pride for MHCA and one they strive hard to maintain.

"This survey is endorsed by the American Health Care Association and we believe these numbers lend a high level of credibility to what we do and how well we do it," said Henderson. "The facilities here in the state can match up with any across the nation as we consistently scored in the lower to mid eighty percent ratings."

One reason for those high numbers, according to Henderson, is in places such as Meridian where the facilities are geared to serving the community in more intimate ways, the relationships between the staff and residents is much more heartfelt simply because everyone knows each other and therefore cares for one another in greater measure.

"There is a higher level of trust in facilities in Meridian than in places such as Jackson or the Gulf Coast," she said.

But the foundation also strives to do much more in regards to its residents and the staff who serve them.

A new, highly anticipated program geared toward awarding scholarships for continuing education in long-term health care fields, including nursing and social work, have officials excited about the future especially at a time when it is still very hard to fully staff long-term care homes.

"We have to battle the nursing shortage just like hospitals," Henderson pointed out. "But we haven't been sitting around doing nothing."

Forging alliances with the Office of Nursing Workforce through the Mississippi Nurses Association and the Department of Labor has reaped benefits that will only grow as the years progress.

"Our basic goal is to train new nurses and retain the ones we have," said Causey. "We, along with Meridian Community College, have begun a program in which high school juniors and seniors could benefit greatly if a medical profession is their goal."

The program allows the juniors and seniors to take nursing courses that will enable them, once they graduate high school, to begin a six month clinical period at a local facility. Upon successful completion of that phase of the education, the student will then be eligible to take the Mississippi State Nursing Board test. It is the fast track, and many officials believe the smartest route, to becoming a medical professional virtually right out of high school.

"This is huge," Henderson said.

One of the big reasons this is very important news to prospective nursing students is because unlike nursing homes of the past, many of the residents need acute care.

"Nursing students, of which I was one earlier in my career, always looked down on nursing home care as a medical profession," said Kennedy. "We don't just change bed pans anymore. We have to set up IVs, and work closely with doctors just like on a general surgery floor of any hospital. This is medical care and patient interaction on a professional level."

It is a sign of expanded care Henderson has watched evolve throughout the years. And with the influx of the Baby Boomer generation, there is going to be an even bigger demand in the very near future.

"We've had to adjust with the population needs," said Henderson. "Our member facilities are at ninety percent capacity right now and with that many people with so many different conditions and demands we've had to diversify and change with the times."

Changing with the times means big business and a huge economic impact to the state.

According to figures provided by the MHCA, there is a $1.1 billion direct effect on the state's economy due solely to the 202 nursing facilities. That translates to more than $78.5 million generated in state and local taxes and another $152 million generated in federal taxes by Mississippi's long-term care facilities.

Nursing homes are no longer the quiet, out of the way local business where hardly a word is heard from. In the 21st century they are an industry all in themselves.